Can you die of a broken heart? Science says, ‘maybe’, and holiday stress doesn’t help

Can you die of a broken heart? Science says, 'maybe'

The holidays can be tough. The commercialization that comes with the occasion places pressure on everyone — but perhaps the most pressure falls on the lonely. This, at least, was what I was thinking while I sat in on a fascinating presentation recently at a conference for primary-care physicians staged by Vancouver’s St. Paul’s Hospital.

The presentation was about something called takotsubo syndrome, also known as stress cardiomyopathy, or “broken heart” syndrome, and it was presented by Dr. Carolyn Taylor, a St. Paul’s cardiologist. For reasons no one understands, the syndrome’s classic victims are older women. They show up in the emergency room complaining of symptoms that sound like a heart attack: chest pain, inability to breathe, lightheadedness, possible nausea or sweating. In such situations, ER docs will test for cardiac enzymes, conduct electrocardiogram monitoring and perhaps check the arterial blood flow with imaging technologies, such as an angiogram. But they don’t find any blockage. Rather, if they conduct an echocardiogram or a cardiac MRI, they find the heart’s left ventricle has spasmed into a strange shape, with muscle tissue massed toward the ventricular opening. The result is an interruption in blood flow, just like a heart attack.

In Japan, where the syndrome first was diagnosed in 1991, physicians thought the ventricle looked like a takotsubo pot, a pottery vessel that Far East fishermen use to trap octopi. Since then, docs have found that all sorts of events can bring on the condition.

One of North America’s best-known experts on the phenomenon is a cardiologist at the Minnesota Heart Institute known as Scott Sharkey. One of his studies tracked people who presented with the syndrome from the years 2001 to 2008 — 136 people all told between the ages of 32 and 94, 130 women and six men. The most common cause of the takotsubo was emotion-related, Sharkey reported. Triggers included heated arguments with family members, relationship breakups, and the deaths of loved ones. One case was triggered by the death of two pet dogs.

We say it’s possible to die of a broken heart. That applies to broken heart syndrome as well. In Sharkey’s study, three people died from the actual takotsubo spasm, and death struck another 17 of subsequent related causes — creating a survival rate of 85%. Most people do survive broken heart syndrome, just like they survive a broken heart.

But what strikes me about all this is the way our emotions can affect our physical body. There’s growing evidence our emotions also can assist our physical health. Laughter, for example. I was struck this year by the story of the comedian Tig Notaro, who performed an already legendary stand-up comedy routine the week she was diagnosed with cancer in both her breasts. That happened in July; since then, she’s had a double mastectomy and her prognosis is positive. Did her ability to laugh at her dire situation assist her body in getting through the trauma?

Studies suggest it may have helped. There’s the classic 1976 article by Norman Cousins in the New England Journal of Medicine that posited 10 minutes of laughter brought on by comedy films featured an analgesic effect. It makes sense — laughter releases hormones called endorphins, which can relieve pain. More recently, evolutionary psychologist Robin Dunbar of Oxford University attempted to quantify the effect. He tested subjects’ pain tolerance, then divided the subjects into two groups. One group watched serious documentaries, the other, funny web videos. Then, once again, he measured the two groups’ pain tolerance — and suddenly, the funny web video group could tolerate more pain than they could before. (The serious documentary group could not.)

The takeaway from all this? Amid holiday life’s hustle and bustle, the parties and the shopping, we’re sometimes tempted to forget about our emotional lives. The holidays can be difficult for everybody. For some, they could even lead to a broken heart and a cardiac event. Stress can stem from loneliness, anxiety or the myth that everyone else is having a good time and engaged in loving family relationships (without arguments). We should also remember our emotions also can help our bodies. Remember smiles are contagious and laughter may be therapeutic. Remember the holidays are about giving rather than receiving—and the world’s best gift may be sharing smiles and a heartfelt hug.

—Dr. James Aw is the medical director of the Medcan Clinic, a leading private health clinic in Toronto. For more information, visit medcan.com.